Individual provider Active NPI

Louise Anne Justus, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Adrian, MI
National Provider Identifier
1669508404
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601003453 Issued in MI
Practice address
901 Kimole LN
Adrian, MI 49221-1491
Phone
(517) 263-6140
Fax
(517) 265-6796
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601003453 MI Primary

Addresses

Primary practice location

901 Kimole LN
Adrian, MI 49221-1491

Mailing address

901 Kimole LN
Adrian, MI 49221-1491
Phone (517) 263-6140

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ljustus7910@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090928000247 MI Practitioner - Physician Assistant 4981750387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Central Corporation of MichiganGroup PAC ID 7012902265, 112 clinicians

Practice addresses (Care Compare)

146 S Charles St
Adrian, MI 49221-2556
Phone (517) 366-5000

200 E Russell Rd
Unit C
Tecumseh, MI 49286-2072
Phone (517) 263-9491

400 N Main St
Suite a
Onsted, MI 49265-9203
Phone (517) 366-5025

Hospital & facility affiliations

  • Elara Caring Home health agency, Jackson, MI, CCN 237274
  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Promedica Monroe Regional Hospital Hospital, Monroe, MI, CCN 230099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601003453MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Health Services, LTD Past Accepting new patients
Emma L Bixby Medical Center Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1669508404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 KIMOLE LN",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211491",
            "telephone_number": "517-263-6140",
            "fax_number": "517-265-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 KIMOLE LN",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211491",
            "telephone_number": "517-263-6140",
            "fax_number": "517-265-6796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTUS",
        "first_name": "LOUISE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601003453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ljustus7910@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.